Practice-based research is crucial for improving oral health. The National Institute of Dental and Craniofacial Research (NIDCR) plans to continue and extend its practice-based research initiative, begun with a $75 million investment to establish three practice-based research networks (PBRNs) in 2005. At present, research data in dental PBRN studies are recorded and entered into the computer through a process that is separate from that used to manage clinical data. The studies do not reuse data that a clinician may already have recorded in an electronic dental record (EDR). Thus, dental PBRNs forego the many benefits of reusing data from electronic patient records for research, such as making clinical data available immediately for clinical, epidemiologic and outcomes research; reducing or avoiding secondary data entry; and facilitating longitudinal data collection and conducting cross-PBRN studies. The long-term goal of our research is to use data from EDR to improve patient care and its outcomes. The objective of this project is to develop a generalizable method for extracting EDR data for practice-based clinical research, using Dentrix as the test system. In our first specific aim, we will determine the utilization of clinical data elements useful for research by practitioners by mining the electronic dental records of 100 Dentrix users and generating summary statistics about patient documentation patterns by data field. The second specific aim will develop a technical Infrastructure for extracting data from Dentrix and integrating them with manually collected research data. We will configure Dentrix's eSync product, a program that allows external computer systems to extract data from a Dentrix database, to reuse selected data for clinical research. In the last specific aim, we will pilot-test the feasibility of conducting a clinical study using the infrastructure in five dental practices. In the process, we will validate the completeness and correctness of research data extracted from Dentrix and evaluate system efficiency, usability and user acceptance. The main outcome of this project will be the electronic Dental Practice-Based Research Network, a generalizable method for extracting clinical data from EDRs and reusing them for practice-based research. The ePBRN will be architected to be extensible to any EDR, as our partnering organization, the electronic medical PBRN Distributed Ambulatory Research in Therapeutics Network has already done. The approach we will develop will facilitate practice-based research by reducing clinician workload and secondary data entry, thereby increasing efficiency; making data available for real-time validation and integration into study data sets; and providing an impetus for designing research functions into EDRs. The methods we will develop can also be used for real-time epidemiologic surveys, development of disease registries and the monitoring of disease outbreaks. This project is a first step in making the increasing amount of electronic clinical data available for improving research, clinical care and patient outcomes.